Embedding public involvement in research prioritisation for public health research in local councils: Lessons from NIHR Health Determinants Research collaboration Medway.

Background: NIHR Health Determinants Research Collabora tions, led by local government, are at the forefront of ree sarch to tackle the wider determinants of health in the UK. We report on how NIHR HDRC Medway has addressed one of the key challenges for HDRCS: establishing mechanisms by which the public voice can be involved in prioritising research questions in these novel Local Authority settings. Specifically, we aimed to develop an equitable, transparent and responsive system for research prioritisation that supports local residents to contribute ideas for research prioritisation, as well as to contribute to development and review of the research prioriti sation system.

Methods: We established a research prioritisation working group (RPWG) comprising members of our Public Advisory Group (PAG) and executive team. We worked as a RPWG to co-design criteria for use with the Analytic Hierarchy Process (AHP) that determines scores for proposed research questions, and to co-design the broader system supporting local residents to submit those research questions.

Results: Two PAG members elected to join the RPWG. The initial list of nine criteria identified by informal literature review was reduced to three criteria by the RPWG. A Priority Setting Partnership (PSP) was established to review these crite ria further, to use pairwise comparisons to develop a scoring system reflecting their relative importance (the AHP) and to annually review how those scores are applied to incoming research questions. To further embed the public voice, it was decided that of the 20 PSP members, four to five should be Medway residents and a further three should be members of Medway charities or not-for-profit organisations.

Discussion: A co-design approach to developing and delivering a responsive research prioritisation process is tractable and meets HDRC remit in addressing wider determinants of health of relevance to local communities without needing to limit the prioritisation to certain health issues. The use of AHP (to pro vide a transparent and equitable means of prioritisation) was decided before the RPWG was formed and initial draft criteria were identified by informal literature review without lay input. Annual evaluation of our process may identify limitations to our research prioritisation process. Our next step is to co design the process by which members of the public – includ ing those from under-served communities - can submit research ideas. Our experience suggests that embedding public voice in process development in other areas of population health research is likely to be fruitful.